DR TRUNKEY: IN the next hour or hour and 5 minutes, we will be addressing a problem within medicine and, in particular, in surgery. This is the issue of competency. We will try to limit our comments to about 10 minutes; that will give time for the audience to ask questions. I will address the issues of early and late competency, Dr Dunnington is going to take the issues of the ACGME's [Accreditation Council for Graduate Medical Education's] 6 guidelines for competency, and Tom Russell, representing the American College of Surgeons, is going to address this from the standpoint of processes that the College has initiated to address this very important issue.